Comparison Of Clinical Value Of Laparoscopic And Open Hepatectomy In Accelerated Recovery Of Hepatocellular Carcinoma

Objective To compare the clinical value of laparoscopic and open hepatectomy in the treatment of primary hepatocellular carcinoma.Methods Retrospective analysis of the complete clinical data of 77 patients with primary hepatocellular carcinoma and hepatectomy in the Provincial Hospital of Anhui Medical University from January 2016 to December 2017.Among them,37 cases underwent laparoscopic hepatectomy and 40 cases underwent open hepatectomy.The age,sex,Child-Pugh classification,tumor size,alpha-fetoprotein(AFP),hepatitis B surface antigen,and surgery were compared by statistical analysis.Mid-bleed volume,intraoperative blood transfusion,operation time,postoperative ventilation time,3days postoperative drainage,postoperative hospital stay,total treatment cost,drainage tube removal time,preoperative liver function,liver function after 3 days postoperatively The incidence of postoperative explosive pain,the time of postoperative outpatient activity,and the incidence of postoperative complications.Results The postoperative pathological results of 77 patients with hepatocellular carcinoma who underwent surgery were confirmed as hepatocellular carcinoma.There was no significant difference in the baseline data between the two groups(P>0.05).The intraoperative blood loss was(205.4 ± 107.9)ml in the laparoscopic group and(261.3±99.7)ml in the open group.The operation time was(143.2±50.8)min in the laparoscopic group and(169.7 ± 51.4)min in the open group.The above indicators were significantly less in the laparoscopic group than in the open group(P<0.05).The laparoscopic group had a postoperative ventilation time of(2.0 ± 1.0)days,postoperative hospital stay(6.8±2.4)days,and postoperative outpatient activity time(2.46±0.99)days,which was significantly less than that of the open group(2.8).±0.8)days,(8.7±2.8)days and(3.25±1.17)days;the incidence of fulminant pain was 16.2%in the laparoscopic group,and the complication rate was 18.9%,which was significantly lower than that in the open surgery group.% and 40.0%%,the difference was statistically significant(P<0.05).The cost of treatment was(31372.8±8060.3)in the laparoscopic group,which was also significantly lower than that in the open group(37440.0±10366.5)(P<0.05).There were 7 complications in the laparoscopic group,including 7 cases of postoperative thoracic and ascites effusions;16 cases of complications occurred in the open group,including 13 cases of postoperative thoracic and ascites effusion,wound infection,liquefaction,hematoma In 2 cases,one case of postoperative bile leakage,the difference of postoperative complications between the two groups was statistically significant(P<0.05).Conclusion Laparoscopic hepatectomy for primary hepatocellular carcinoma is more effective than open abdominal resection,which can reduce the incidence of postoperative fulminant pain and surgical complications.It is beneficial for patients to get out of bed early and promote intestinal function recovery.Small surgery on liver function damage,shorten hospital stay,and reduce patient care costs.